| NPI | 1013149616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BASIL QANDIL Owner 313-871-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI 4301087756) |
| Enumeration Date | 2009-08-14 |
| Last Update Date | 2010-08-18 |